Sadural Ernani, Riley Kristen E, Zha Peijia, Pacquiao Dula, Faust Amanda
Department of Obstetrics and Gynecology, Cooperman Barnabas Medical Center, RWJBarnabas Health, Livingston, NJ, United States.
School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ, United States.
JMIR Form Res. 2022 Jun 13;6(6):e37777. doi: 10.2196/37777.
Maternal morbidity and mortality in the United States continue to be a worsening public health crisis, with persistent racial disparities among Black women during the COVID-19 pandemic. Innovations in mobile health (mHealth) technology are being developed as a strategy to connect birthing women to their health care providers during the first 6 weeks of the postpartum period.
This study aimed to inform a process to evaluate the barriers to mHealth implementation in the context of the COVID-19 pandemic by exploring the experiences of mothers and stakeholders who were directly involved in the pilot program.
The qualitative design used GoToMeeting (GoTo) individual interviews of 13 mothers and 7 stakeholders at a suburban teaching hospital in New Jersey. Mothers were aged ≥18 years, able to read and write in English or Spanish, had a vaginal or cesarean birth at >20 weeks of estimated gestational age, and were admitted for delivery at the hospital with at least a 24-hour postpartum stay. Stakeholders were part of the hospital network's obstetrics collaborative subcommittee comprising administrators, physicians, registered nurses, and informatics. Responses were transcribed verbatim and analyzed for emerging themes. The socioecological framework provided a holistic lens for analyzing the multilevel influences on individual experiences.
A total of 3 major themes were identified: mothers experienced barriers from personal situations at home and with services in the hospital and community, which were intensified by the COVID-19 pandemic; the COVID-19 pandemic negatively impacted hospital services, priorities, and individual staff; and mothers and stakeholders had positive experiences and perceptions of the mHealth intervention.
The use and reach of the mHealth intervention were negatively influenced by interrelated factors operating at multiple levels. The system-wide and multilevel impact of the pandemic was reflected in participants' responses, providing evidence for the need to re-evaluate mHealth implementation with more adaptable systems and structures in place using a socioecological framework.
美国孕产妇的发病和死亡情况仍然是日益严重的公共卫生危机，在新冠疫情期间，黑人女性中持续存在种族差异。移动健康（mHealth）技术创新正在被开发出来，作为一种在产后六周内将分娩女性与她们的医疗服务提供者联系起来的策略。
本研究旨在通过探索直接参与试点项目的母亲和利益相关者的经历，为评估新冠疫情背景下移动健康实施障碍的过程提供信息。
采用定性设计，通过GoToMeeting（GoTo）对新泽西州一家郊区教学医院的13位母亲和7位利益相关者进行了个人访谈。母亲年龄≥18岁，能够用英语或西班牙语读写，在估计孕周>20周时进行了阴道分娩或剖宫产，并在该医院住院分娩且产后至少停留24小时。利益相关者是医院网络产科协作小组委员会的成员，包括管理人员、医生、注册护士和信息学专家。对回答进行逐字转录并分析新出现的主题。社会生态框架为分析对个人经历的多层次影响提供了一个整体视角。
共确定了3个主要主题：母亲们在家中的个人情况以及医院和社区服务方面遇到障碍，新冠疫情加剧了这些障碍；新冠疫情对医院服务、优先事项和个别工作人员产生了负面影响；母亲和利益相关者对移动健康干预有积极的体验和看法。
移动健康干预的使用和覆盖范围受到多个层面相互关联因素的负面影响。疫情在全系统和多层次的影响反映在参与者的回答中，为使用社会生态框架以更具适应性的系统和结构重新评估移动健康实施的必要性提供了证据。
